Benefits Forms

Health and Dental Claim Forms

Clinical Faculty

CUPE 2692 and IUOE 772

UWOFA, UWOFA-L&A, CUPE 2361, PMA, UWOSA, SAGE, Western Special Constable Service (OPSEU) and Postdoctoral Associates

  • Extended Health Care Claim Form - use this form to seek reimbursement for extended Health and Dental claims, including Vision Care, and reimbursement from your Health Care Spending Account.
  • Group Benefits Dental Claim Form - if your dentist does not directly bill Manulife on your behalf, have the dentist enter the claim information on this form.


Other Benefit Forms

Educational Assistance Forms

Published on  and maintained in Cascade CMS.